Referrals to the Advanced Endodontics Clinic
The Advanced Endodontics Clinic accepts referrals from the Memphis community and beyond. We are a full service endodontic practice staffed with postdoctoral residents, supervised by experienced faculty clinicians.
We value our relationship with referring doctors and are committed to meeting and exceeding your professional needs by providing timely communication and efficient referral service. If interested in referring a patient for clinical evaluation and endodontic treatment, please feel free to directly contact the Advanced Endodontics Clinic:
Endodontics Patient Referral Form
Completion of a referral form is mandatory for treatment. Once completed online you should press the “email” button which will deliver the information to our secure server. Any digital radiographs can also be emailed directly to firstname.lastname@example.org.
Remember to identify the radiograph with the referral form when emailing.
Please note we are a paperless office and would prefer all communications via email.
Use our online PDF form to conveniently submit the form from home or work. Please download the free plug-in from Adobe's web site, if it is not already installed on your system. It is important that you have the latest version of the plug-in to successfully use our online form.
Please note Apple’s Preview application and plug-in does not handle interactive forms properly. You must use the Adobe Reader application.
Department of Endodontics
875 Union Avenue
Memphis, TN 38163